Objective:

To present a case of recurrent uterine inflammatory myofibroblastic tumor (IMT) with IGFBP5-ALK fusion, highlighting its significance in treatment response to sequential ALK-TKI therapy.

Approach:

Key Findings:

• The patient achieved complete response to iruplinalkib after resistance to crizotinib, marking a significant advancement in treatment options.
• This case is the first reported instance of iruplinalkib achieving therapeutic success in uterine IMT, suggesting new avenues for targeted therapy.
• Molecular profiling identified IGFBP5-ALK fusion as a key factor in the tumor's pathology, underscoring the importance of genetic testing.

Interpretation:

Sequential treatment with ALK-TKIs, particularly iruplinalkib, may be an effective strategy for managing ALK-rearranged uterine IMTs.

Limitations:

• This is a single case report, limiting generalizability; further studies are needed to validate these findings.
• Long-term efficacy and safety of iruplinalkib in larger populations remain to be established, which is crucial for clinical application.

Conclusion:

Iruplinalkib demonstrated significant therapeutic potential in a case of recurrent uterine IMT with IGFBP5-ALK fusion.

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